Abstract
Software-based MRI/TRUS fusion biopsy depends on the coordination of several steps, and inter-examiner differences could influence the results. The aim of this bicentric prospective study was to compare the detection rates of MRI/TRUS fusion targeted biopsy (TG) and systematic biopsy (SB), and the detection rates of examiners with different levels of previous experience in prostate biopsy. A total of 419 patients underwent MRI based on a suspicion of prostate cancer with elevated PSA levels. MRI was positive in 395 patients (221 in the first biopsy group [FB] and 174 in the repeated biopsy group [RB]). A subsequent TG, followed by a SB, was performed on these patients by four different examiners. In the detection of clinically significant prostate cancer, a significant difference was found for TG+SB against SB in the RB group (35.1% vs. 25.3%, P=0.047). In the detection of clinically insignificant prostate cancer, the SB had a significantly higher detection rate than TG in both subgroups (FB: 11.9% vs. 4.7%, P=0.008; RB: 13.8% vs. 6.9%, P=0.034). A significant difference was found between the four examiners in the FB for TG (P=0.028), SB (P=0.036), and TG+SB (P=0.017). MRI/TRUS TG in combination with SB had significantly higher detection rates than SB in the RB group only. Differences in detection rates between examiners were dependent on the level of previous experience with TRUS guided biopsy.
Highlights
PATIENT AND METHODSThe current diagnostic algorithm for prostate cancer detection based on PSA and subsequent systematic TRUS guided biopsy could be improved by adding mpMRI and targeted biopsy of MRI lesions[1,2]
A significant difference was found for targeted biopsy (TG)+systematic biopsy (SB) vs. SB in the repeated biopsy (RB) group for the detection of clinically significant prostate cancer (Fig. 1)
A significant difference was found among the four examiners in the first biopsy (FB) group for TG, SB, and TG +SB
Summary
PATIENT AND METHODSThe current diagnostic algorithm for prostate cancer detection based on PSA and subsequent systematic TRUS guided biopsy could be improved by adding mpMRI and targeted biopsy of MRI lesions[1,2]. Software-based MRI/TRUS fusion biopsy is dependent on the coordination of several procedural steps, and interexaminer differences could influence biopsy results. To the best of our knowledge, no studies have investigated the effect of examiner performance on the outcome of prostate fusion biopsy The aim of this prospective study was to compare the detection rates of MRI/TRUS fusion targeted biopsies (TGs) and systematic biopsies (SBs), and the detection rates of different examiners performing these prostate biopsies. Software-based MRI/TRUS fusion biopsy depends on the coordination of several steps, and inter-examiner differences could influence the results. The aim of this bicentric prospective study was to compare the detection rates of MRI/TRUS fusion targeted biopsy (TG) and systematic biopsy (SB), and the detection rates of examiners with different levels of previous experience in prostate biopsy. Differences in detection rates between examiners were dependent on the level of previous experience with TRUS guided biopsy
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